中文摘要：

目的评价CT检查对食管癌不同区域淋巴结转移的诊断效能。方法回顾性分析618例行根治性切除术的食管癌病例，术前均行胸、腹部CT扫描，观察测量CT所示下颈区，上、中、下纵隔区及上腹区淋巴结的大小及个数，判断转移情况，与术后病理相对照。结果全组淋巴结转移率为39．2％，其中中纵隔和上腹区的淋巴结转移率较高，分别为18．8％和21．4％。术前CT对食管癌淋巴结转移诊断的灵敏度、特异度、阳性预测值、阴性预测值、Youden指数分别为58．3％、70．7％、56．2％、72．5％、0．290。CT诊断下颈区淋巴结转移的灵敏度最高（50．0％），Youden指数亦最大（0．334），诊断效能最高，对下纵隔淋巴结转移的诊断，敏感性最低（仅8．7％），Youden指数只有0．074。结论术前CT扫描能比较准确地反映食管癌淋巴结转移的分布规律，其中对下颈区淋巴结转移的诊断效能最高。

英文摘要：

Objective To evaluate the diagnostic efficiency of CT for estimation of lymph node metastasis m esopnageai carcinoma. Methods 618 patients with esophageal carcinoma after radical resection underwent chest and abdominal CT examinations before surgery. The lymph node＇s size and number in lower neck, upper-mediastinum, middle-mediastinum, lower-mediastinum and superior abdominal regions were evaluated on CT images and compared with postoperative pathology. Results The rate of lymph node metastasis was 39.2 % in all patients,and it was higher in middle-mediastinum and superior abdomen regions（ 18.8% and 21.4 %, respectively）. The sensitivity, specificity, positive predictive value, negative predictive value and Youden＇s index in evaluating lymph node metastasis with preoperative CT scan were 58.3M, 70.7%, 56.2%, 72.5% and 0. 290,respectively. For lower neck region, the sensitivity in evaluation of lymph node metastasis with CT was the highest （ 50.0 % ） and the Youden＇ s index was the highest too （0. 334）. For lower-mediastinum region, the sensitivity in evaluating lymph node metastasis with CT was the lowest （only 8.7 %）, the Youden＇s index only was 0. 074. Conclusion Preoperative CT image can rarely predict the distribution patterns of the lymph node metastasis in esophageal carcinoma. The diagnostic efficiency of CT for lower neck region of lymph node metastasis of esophageal carcinoma is the highest.